羊水过多、机械性损伤与孕晚期妇女胎盘早剥的关联性探究

Study on the Correlation between Excessive Amniotic Fluid,Mechanical Damage and Placental Abruption in Women in the Third Trimester

目的探究羊水过多、机械性损伤与孕晚期妇女胎盘早剥的关联性。方法选取南阳市中心医院98例孕晚期胎盘早剥妇女为胎盘早剥组(2016年8月-2019年6月),并选取同期健康孕晚期妇女125例为参照组,收集两组临床资料,探究羊水过多、机械性损伤与孕晚期妇女胎盘早剥的关联性。结果胎盘早剥组妊娠期高血压综合征、胎膜早破、机械性损伤及羊水过多发生率高于参照组(P<0.05);经Logistic多因素回归分析,胎膜早破、羊水过多、妊娠期高血压综合征、机械性损伤是孕晚期妇女胎盘早剥的独立危险因素(P<0.05);胎盘早剥对母婴结局的影响:剖宫产56.12%,大出血23.47%,子宫切除5.10%,子宫胎盘卒中12.24%,弥漫性血管内凝血9.18%,低体质量儿23.47%,胎儿窘迫27.55%,新生儿窒息24.49%,围生儿死亡8.16%。结论胎膜早破、羊水过多、妊娠期高血压综合征、机械性损伤是孕晚期妇女胎盘早剥的独立危险因素,临床应尽早明确上述危险因素,为实施针对性处理措施提供循证数据支持。

Objective To study the correlation between excessive amniotic fluid,mechanical damage and placental abruption in women in the third trimester.Methods A total of 98 women with placental abruption in the third trimester of nanyang city central hospital were selected as the placental abruption group(from August 2016 to June 2019),and 125 healthy women in the third trimester were selected as the reference group.Two groups of clinical data were collected to explore the correlation between excessive amniotic fluid,mechanical injury and placental abruption in women in the third trimester.Results The incidence of gestational hypertension syndrome,premature rupture of membranes,mechanical injury and excessive amniotic fluid in the placental abruption group was higher than that in the control group(P<0.05).Logistic multivariate regression analysis showed that premature rupture of membranes,excess amniotic fluid,gestational hypertension syndrome and mechanical injury were independent risk factors for placental abruption in women in the third trimester(P<0.05).Effects of placental abruption on maternal and infant outcomes were following:cesarean section 56.12%,massive hemorrhage 23.47%,hysterectomy 5.10%,uterine placental stroke 12.24%,diffuse intravascular coagulation 9.18%,children with low body mass 23.47%,fetal distress 27.55%,neonatal asphyxia 24.49%,perinatal death 8.16%.Conclusion Premature rupture of membranes,excess amniotic fluid,gestational hypertension syndrome and mechanical injury are independent risk factors for placental abruption in women in the third trimester.